M. Matsumoto is the chief researcher of this study and wrote the entire paper. M. Okayama and E. Kajii are the project managers of the Rural Health White Paper Survey, part of which is the data of this study. As a specialist of health service research and statistics, K. Inoue supported the first author to write the entire paper.

Keywords:

diffusion;

Japan;

rural;

technology

Abstract

Context: Japanese medical facilities are noted for being heavily equipped with high-tech equipment compared to other industrialised countries. Rural facilities are anecdotally said to be better equipped than facilities in other areas due to egalitarian health resource diffusion policies by public sectors whose goal is to secure fair access to modern medical technologies among the entire population.

Objectives: To show the technology status of rural practice and compare it to the national level.

Design: Nationwide postal survey.

Setting, Subjects & Interventions: Questionnaires were sent to the directors of 1362 public hospitals and clinics (of the 1723 municipalities defined as ‘rural’ by four national laws). Information was collected about the technologies they possessed. The data were compared with figures from a national census of all hospitals and clinics.

Results: A total of 766 facilities responded (an effective response rate of 56%). Rural facilities showed higher possession rates in most comparable technologies than the national level. It is noted that almost all rural hospitals had gastroscopes and colonoscopes and their possession rates of bronchoscopes and dialysis equipment were twice as high as the national level. The discrepancy in possession rates between rural and national was even more remarkable in clinics than in hospitals. Rural clinics owned twice as many abdominal ultrasonographs, and three times as many gastroscopes, colonoscopes, defibrillators and computed tomography scanners as the national level.

Conclusions: Rural facilities are equipped with more technology than urban ones. Government-led, tax based, technology diffusion in the entire country seems to have attained its goal.

What is already known on this subject: As a general tendency in both developing and developed countries, rural medical facilities are technologically less equipped than their urban counterparts.

What does this paper add?: In Japan, rural medical facilities are technologically better equipped than urban facilities.